Post-traumatic stress disorder can be predicted in hospitalized blunt trauma patients using a simple screening tool
Background Post-traumatic stress disorder (PTSD) has debilitating psychiatric and medical consequences. The purpose of this study was to identify whether PTSD diagnosis and PTSD symptom scale score (PTSD severity) could be predicted by assessing peritraumatic experiences using a single question or s...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2021-03-01
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| Series: | Trauma Surgery & Acute Care Open |
| Online Access: | https://tsaco.bmj.com/content/6/1/e000623.full |
| _version_ | 1797685586345066496 |
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| author | Peter Rhee Maria Khan Saad Rahmat Jessica Velez Muhammad Farooqi Abbas Smiley Kartik Prabhakaran Rhea Dornbush Stephen Ferrando Yvette Smolin |
| author_facet | Peter Rhee Maria Khan Saad Rahmat Jessica Velez Muhammad Farooqi Abbas Smiley Kartik Prabhakaran Rhea Dornbush Stephen Ferrando Yvette Smolin |
| author_sort | Peter Rhee |
| collection | DOAJ |
| description | Background Post-traumatic stress disorder (PTSD) has debilitating psychiatric and medical consequences. The purpose of this study was to identify whether PTSD diagnosis and PTSD symptom scale score (PTSD severity) could be predicted by assessing peritraumatic experiences using a single question or screening tools at different time points in patients hospitalized after admission to the hospital after significant physical trauma, but with stable vitals (level II trauma).Methods Patients completed the ‘initial question’ and the National Stressful Events Survey Acute Stress Disorder Scale (NSESSS) at 3 days to 5 days after trauma (NSESSS-1). The same scale was administered 2 weeks to 4 weeks after trauma (NSESSS-2). The Posttraumatic Stress Disorder Symptoms Scale Interview for DSM-5 (PSSI-5) was administered 2 months after trauma. PTSD diagnosis and PTSD severity were extracted from the PSSI-5. Linear multivariate regression analyses were used to establish whether scores for NSESSS-1 or NSESSS-2 predicted PTSD diagnosis/PTSD severity. Non-linear multivariate regression analyses were performed to better understand the relationship between NSESSS-1/NSESSS-2 and PTSD diagnosis/PTSD severity.Results A single question assessing the experience of fear, helplessness, or horror was not an effective tool for determining the diagnosis of PTSD (p=0.114) but can be a predictor of PTSD severity (p=0.039). We demonstrate that administering the NSESSS after either 3 days to 5 days (p=0.008, p<0.001) or 2 weeks to 4 weeks (p=0.039; p<0.001) can predict the diagnosis of PTSD and PTSD severity. Scoring an NSESSS above 14/28 (50%) increases the chance of experiencing a higher PTSD severity substantially and linearly.Discussion Our initial question was not an effective predictor of PTSD diagnosis. However, using the NSESSS at both 3 days to 5 days and 2 weeks to 4 weeks after trauma is an effective method for predicting PTSD diagnosis and PTSD severity. Additionally, we show that patients who score higher than 14 on the NSESSS for acute stress symptoms may need closer follow-up.Level of evidence Level III, prognostic. |
| first_indexed | 2024-03-12T00:46:18Z |
| format | Article |
| id | doaj.art-aaf69be0ebe7419ab3c44195b80af9c1 |
| institution | Directory Open Access Journal |
| issn | 2397-5776 |
| language | English |
| last_indexed | 2024-03-12T00:46:18Z |
| publishDate | 2021-03-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | Trauma Surgery & Acute Care Open |
| spelling | doaj.art-aaf69be0ebe7419ab3c44195b80af9c12023-09-14T15:55:07ZengBMJ Publishing GroupTrauma Surgery & Acute Care Open2397-57762021-03-016110.1136/tsaco-2020-000623Post-traumatic stress disorder can be predicted in hospitalized blunt trauma patients using a simple screening toolPeter Rhee0Maria Khan1Saad Rahmat2Jessica Velez3Muhammad Farooqi4Abbas Smiley5Kartik Prabhakaran6Rhea Dornbush7Stephen Ferrando8Yvette Smolin9Department of Surgery, Westchester Medical Center, Valhalla, New York, USAMedical College, The Aga Khan University, Karachi, PakistanDepartment of Psychiatry and Behavioral Sciences, Westchester Medical Center, Valahlla, NY, USADepartment of Surgery, Westchester Medical Center Health Network, Valhalla, New York, USADepartment of Psychiatry and Behavioral Sciences, New York Medical College, Valhalla, New York, USADepartment of Surgery, Westchester Medical Center, Valhalla, New York, USASurgery, Westchester Medical Center, Valhalla, New York, USADepartment of Psychiatry and Behavioral Sciences, New York Medical College, Valhalla, New York, USADepartment of Psychiatry and Behavioral Sciences, New York Medical College, Valhalla, New York, USADepartment of Psychiatry and Behavioral Sciences, New York Medical College, Valhalla, New York, USABackground Post-traumatic stress disorder (PTSD) has debilitating psychiatric and medical consequences. The purpose of this study was to identify whether PTSD diagnosis and PTSD symptom scale score (PTSD severity) could be predicted by assessing peritraumatic experiences using a single question or screening tools at different time points in patients hospitalized after admission to the hospital after significant physical trauma, but with stable vitals (level II trauma).Methods Patients completed the ‘initial question’ and the National Stressful Events Survey Acute Stress Disorder Scale (NSESSS) at 3 days to 5 days after trauma (NSESSS-1). The same scale was administered 2 weeks to 4 weeks after trauma (NSESSS-2). The Posttraumatic Stress Disorder Symptoms Scale Interview for DSM-5 (PSSI-5) was administered 2 months after trauma. PTSD diagnosis and PTSD severity were extracted from the PSSI-5. Linear multivariate regression analyses were used to establish whether scores for NSESSS-1 or NSESSS-2 predicted PTSD diagnosis/PTSD severity. Non-linear multivariate regression analyses were performed to better understand the relationship between NSESSS-1/NSESSS-2 and PTSD diagnosis/PTSD severity.Results A single question assessing the experience of fear, helplessness, or horror was not an effective tool for determining the diagnosis of PTSD (p=0.114) but can be a predictor of PTSD severity (p=0.039). We demonstrate that administering the NSESSS after either 3 days to 5 days (p=0.008, p<0.001) or 2 weeks to 4 weeks (p=0.039; p<0.001) can predict the diagnosis of PTSD and PTSD severity. Scoring an NSESSS above 14/28 (50%) increases the chance of experiencing a higher PTSD severity substantially and linearly.Discussion Our initial question was not an effective predictor of PTSD diagnosis. However, using the NSESSS at both 3 days to 5 days and 2 weeks to 4 weeks after trauma is an effective method for predicting PTSD diagnosis and PTSD severity. Additionally, we show that patients who score higher than 14 on the NSESSS for acute stress symptoms may need closer follow-up.Level of evidence Level III, prognostic.https://tsaco.bmj.com/content/6/1/e000623.full |
| spellingShingle | Peter Rhee Maria Khan Saad Rahmat Jessica Velez Muhammad Farooqi Abbas Smiley Kartik Prabhakaran Rhea Dornbush Stephen Ferrando Yvette Smolin Post-traumatic stress disorder can be predicted in hospitalized blunt trauma patients using a simple screening tool Trauma Surgery & Acute Care Open |
| title | Post-traumatic stress disorder can be predicted in hospitalized blunt trauma patients using a simple screening tool |
| title_full | Post-traumatic stress disorder can be predicted in hospitalized blunt trauma patients using a simple screening tool |
| title_fullStr | Post-traumatic stress disorder can be predicted in hospitalized blunt trauma patients using a simple screening tool |
| title_full_unstemmed | Post-traumatic stress disorder can be predicted in hospitalized blunt trauma patients using a simple screening tool |
| title_short | Post-traumatic stress disorder can be predicted in hospitalized blunt trauma patients using a simple screening tool |
| title_sort | post traumatic stress disorder can be predicted in hospitalized blunt trauma patients using a simple screening tool |
| url | https://tsaco.bmj.com/content/6/1/e000623.full |
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